Legionnairesâ€™ Disease and Use of Tumor Necrosis Factor-Î‘lpha Inhibitors: A Forthcoming Problem?
Keywords:opportunistic infection, Legionnairesâ€™ disease, TNF-Î± inhibitors, immunosuppresion, rheumatic diseases.
Aim: To establish a review in the current literature and to analyze the relation Legionnairesâ€™ disease â€“ TNF-Î± inhibitors, in order to estimate the real indications for such connection.
Material and Methods: The electronic data for PubMed and Google Scholar have been searched, according to the vocabulary: legionellosis, epidemiology, outbreak, diagnosis, pathogenesis, therapy, TNF-Î± inhibitors, indications, side effects, risk of infection. The obtained studies have been selected in English, according to the relevance by the topic.
Results: Selected papers, consisted of ten studies and eight case reports, yielded 35 cases of Legionnaires' disease associated with the use of TNF- Î± inhibitor treatment.
Discussion: There is a prevailing conclusion for increased risk of serious infections while using TNF-Î± inhibitors and also a deficiency of studies for an association of Legionnairesâ€™ disease with the use of TNF-Î± inhibitors. Sub-diagnosing and no-existence of screening before the anti-TNF-Î± therapy blur the factual profile for the researched relation. The possibility for latent infection has not been sufficiently researched.Conclusion: There are indications that Legionnairesâ€™ disease in the therapy with TNF-Î± inhibitors is indeed a forthcoming problem. Additional target researches are required in order to establish the position of Legionnairesâ€™ disease in the mosaic of anti - TNF-Î± therapy.
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